Multiple Sclerosis
Multiple Sclerosis
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DOI：
10.1007/978-981-32-9636-7_14
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发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Kira, Jun-ichi
中科院分区：
文献类型：
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作者：
Yamasaki, Ryo;Kira, Jun-ichi
多发性硬化（MS）是一种炎性脱髓鞘疾病。尽管所有MS患者最初表现出复发缓解过程，但20-50%的患者随后在发病后10-20年进入慢性进展过程，这极大地影响了他们的日常生活活动。全世界有250万MS患者，存在很大的地区和种族差异。特别是生活在欧洲的白种人中有许多MS患者，而这种疾病在亚洲人和非洲人中相对罕见，虽然MS被认为是一种自身免疫性疾病，但其发病机制涉及许多因素，如遗传背景，环境因素和性别。虽然免疫学机制仍有待充分阐明，但自体反应性T细胞侵入中枢神经系统（CNS）组织被认为是疾病的第一步。这些T细胞与髓磷脂抗原反应，并通过释放炎性细胞因子激活细胞毒性T细胞、巨噬细胞和B细胞来引发CNS的脱髓鞘。作为一种治疗选择，除了用皮质类固醇进行急性复发的常规治疗外，最近还开发了疾病修饰疗法以预防MS复发。然而，对于慢性进展阶段仍然很少有有效的治疗方法，因此必须破译慢性进展的机制。
Multiple sclerosis (MS) is an inflammatory demyelinating disorder. Although all MS patients initially show a relapsing-remitting course, 20-50% subsequently enter a chronic progressive course at 10-20 years after onset that greatly influences their activities of daily living. There are 2.5 million MS patients worldwide with large regional and racial differences. In particular, there are many MS patients among Caucasians living in Europe, while the disease is relatively rare in Asians and Africans.Although MS is regarded as an autoimmune disease, many factors such as genetic background, environmental factors, and sex are involved in its pathogenesis. While the immunological mechanisms remain to be fully elucidated, invasion of autoreactive T cells into the central nervous system (CNS) tissue is considered the first step of the disease. These T cells react with myelin antigens and initiate demyelination of the CNS by activating cytotoxic T cells, macrophages, and B cells through the release of inflammatory cytokines. As a treatment option, disease-modifying therapies have recently been developed to prevent the recurrence of MS in addition to conventional treatment with corticosteroids for acute relapse. However, there are still few effective treatments for the chronic progressive phase, and it is thus imperative to decipher the mechanism for chronic progression.